Episode 26 – Mark Laslett & McKenzie method
Mark Laslett is a New Zealand-based lower back pain clinical specialist and physiotherapist.
Mark has published numerous research articles on lower back pain, and during our podcast interview he describes how he treats patients with both acute and chronic pain (pain that has been there for a long time.)
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The McKenzie Method
Mark tells us about the McKenzie approach, which he uses on a daily basis. This approach consists of centralizing pain at one level of the spine (cervical, thoracic, lumbar) through repeated movements. These movements can be flexion, extension or what he calls the lateral shift, which is a kind of sideways glide.
These movements are extremely easy to perform and very accessible, and there are several variations, depending on each person’s abilities.
Ian's Story
A pain that has centralized means that it has gone the other way round; for example, a referred sciatica pain that goes down the leg, sometimes even to the little toe, will gradually work its way up to the back, only to become a very localized pain, the size of a thumb.
Mark tells us about a patient, Ian, he saw at the practice. Ian had been in pain every day for 8 years. Ian’s job as a salesman required him to drive for 8 hours a day, and because of his pain, he had to stop every hour or even every 30 minutes to lie on the ground outside, whether it was snowing, hailing, raining, summer or winter.
Ian arrived at Mark’s office in agony. He’d been suffering from back pain for 8 years. After a long, detailed and thorough interrogation, Mark asked him to perform several repetitions (in flexion). At the end of the session, Ian was almost pain-free. His pain had centralized and almost disappeared. He continued to do his flexion sets in the weeks that followed, and Mark still sees him to make sure everything’s okay. For several years now, Ian has been doing very well and is pain-free. In Ian’s case, it was the flexion movement that provided the solution. Sometimes it’s extension, or lateral shift, depending on the person and their pain.
Alternatives to the McKenzie Method
For some people, the McKenzie method doesn’t work, the pain isn’t centralized, and so other treatments may be proposed to the patient: medication, epidural, injections etc. The physiotherapist may refer the patient to a surgeon, or a doctor for further treatment, and in all cases support the patient in maintaining functional capacity and coping with pain.